Public Act 098-0137
 
HB1005 EnrolledLRB098 05627 RLC 35665 b

    AN ACT concerning health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Mental Health and Developmental
Disabilities Code is amended by changing Sections 2-108 and
2-109 as follows:
 
    (405 ILCS 5/2-108)  (from Ch. 91 1/2, par. 2-108)
    Sec. 2-108. Use of restraint. Restraint may be used only as
a therapeutic measure to prevent a recipient from causing
physical harm to himself or physical abuse to others. Restraint
may only be applied by a person who has been trained in the
application of the particular type of restraint to be utilized.
In no event shall restraint be utilized to punish or discipline
a recipient, nor is restraint to be used as a convenience for
the staff.
    (a) Except as provided in this Section, restraint shall be
employed only upon the written order of a physician, clinical
psychologist, clinical social worker, clinical professional
counselor, or registered nurse with supervisory
responsibilities. No restraint shall be ordered unless the
physician, clinical psychologist, clinical social worker,
clinical professional counselor, or registered nurse with
supervisory responsibilities, after personally observing and
examining the recipient, is clinically satisfied that the use
of restraint is justified to prevent the recipient from causing
physical harm to himself or others. In no event may restraint
continue for longer than 2 hours unless within that time period
a nurse with supervisory responsibilities or a physician
confirms, in writing, following a personal examination of the
recipient, that the restraint does not pose an undue risk to
the recipient's health in light of the recipient's physical or
medical condition. The order shall state the events leading up
to the need for restraint and the purposes for which restraint
is employed. The order shall also state the length of time
restraint is to be employed and the clinical justification for
that length of time. No order for restraint shall be valid for
more than 16 hours. If further restraint is required, a new
order must be issued pursuant to the requirements provided in
this Section.
    (b) In the event there is an emergency requiring the
immediate use of restraint, it may be ordered temporarily by a
qualified person only where a physician, clinical
psychologist, clinical social worker, clinical professional
counselor, or registered nurse with supervisory
responsibilities is not immediately available. In that event,
an order by a nurse, clinical psychologist, clinical social
worker, clinical professional counselor, or physician shall be
obtained pursuant to the requirements of this Section as
quickly as possible, and the recipient shall be examined by a
physician or supervisory nurse within 2 hours after the initial
employment of the emergency restraint. Whoever orders
restraint in emergency situations shall document its necessity
and place that documentation in the recipient's record.
    (c) The person who orders restraint shall inform the
facility director or his designee in writing of the use of
restraint within 24 hours.
    (d) The facility director shall review all restraint orders
daily and shall inquire into the reasons for the orders for
restraint by any person who routinely orders them.
    (e) Restraint may be employed during all or part of one 24
hour period, the period commencing with the initial application
of the restraint. However, once restraint has been employed
during one 24 hour period, it shall not be used again on the
same recipient during the next 48 hours without the prior
written authorization of the facility director.
    (f) Restraint shall be employed in a humane and therapeutic
manner and the person being restrained shall be observed by a
qualified person as often as is clinically appropriate but in
no event less than once every 15 minutes. The qualified person
shall maintain a record of the observations. Specifically,
unless there is an immediate danger that the recipient will
physically harm himself or others, restraint shall be loosely
applied to permit freedom of movement. Further, the recipient
shall be permitted to have regular meals and toilet privileges
free from the restraint, except when freedom of action may
result in physical harm to the recipient or others.
    (g) Every facility that employs restraint shall provide
training in the safe and humane application of each type of
restraint employed. The facility shall not authorize the use of
any type of restraint by an employee who has not received
training in the safe and humane application of that type of
restraint. Each facility in which restraint is used shall
maintain records detailing which employees have been trained
and are authorized to apply restraint, the date of the training
and the type of restraint that the employee was trained to use.
    (h) Whenever restraint is imposed upon any recipient whose
primary mode of communication is sign language, the recipient
shall be permitted to have his hands free from restraint for
brief periods each hour, except when freedom may result in
physical harm to the recipient or others.
    (i) A recipient who is restrained may only be secluded at
the same time pursuant to an explicit written authorization as
provided in Section 2-109 of this Code. Whenever a recipient is
restrained, a member of the facility staff shall remain with
the recipient at all times unless the recipient has been
secluded. A recipient who is restrained and secluded shall be
observed by a qualified person as often as is clinically
appropriate but in no event less than every 15 minutes.
    (j) Whenever restraint is used, the recipient shall be
advised of his right, pursuant to Sections 2-200 and 2-201 of
this Code, to have any person of his choosing, including the
Guardianship and Advocacy Commission or the agency designated
pursuant to the Protection and Advocacy for Developmentally
Disabled Persons Act notified of the restraint. A recipient who
is under guardianship may request that any person of his
choosing be notified of the restraint whether or not the
guardian approves of the notice. Whenever the Guardianship and
Advocacy Commission is notified that a recipient has been
restrained, it shall contact that recipient to determine the
circumstances of the restraint and whether further action is
warranted.
(Source: P.A. 92-651, eff. 7-11-02.)
 
    (405 ILCS 5/2-109)  (from Ch. 91 1/2, par. 2-109)
    Sec. 2-109. Seclusion. Seclusion may be used only as a
therapeutic measure to prevent a recipient from causing
physical harm to himself or physical abuse to others. In no
event shall seclusion be utilized to punish or discipline a
recipient, nor is seclusion to be used as a convenience for the
staff.
    (a) Seclusion shall be employed only upon the written order
of a physician, clinical psychologist, clinical social worker,
clinical professional counselor, or registered nurse with
supervisory responsibilities. No seclusion shall be ordered
unless the physician, clinical psychologist, clinical social
worker, clinical professional counselor, or registered nurse
with supervisory responsibilities, after personally observing
and examining the recipient, is clinically satisfied that the
use of seclusion is justified to prevent the recipient from
causing physical harm to himself or others. In no event may
seclusion continue for longer than 2 hours unless within that
time period a nurse with supervisory responsibilities or a
physician confirms in writing, following a personal
examination of the recipient, that the seclusion does not pose
an undue risk to the recipient's health in light of the
recipient's physical or medical condition. The order shall
state the events leading up to the need for seclusion and the
purposes for which seclusion is employed. The order shall also
state the length of time seclusion is to be employed and the
clinical justification for the length of time. No order for
seclusion shall be valid for more than 16 hours. If further
seclusion is required, a new order must be issued pursuant to
the requirements provided in this Section.
    (b) The person who orders seclusion shall inform the
facility director or his designee in writing of the use of
seclusion within 24 hours.
    (c) The facility director shall review all seclusion orders
daily and shall inquire into the reasons for the orders for
seclusion by any person who routinely orders them.
    (d) Seclusion may be employed during all or part of one 16
hour period, that period commencing with the initial
application of the seclusion. However, once seclusion has been
employed during one 16 hour period, it shall not be used again
on the same recipient during the next 48 hours without the
prior written authorization of the facility director.
    (e) The person who ordered the seclusion shall assign a
qualified person to observe the recipient at all times. A
recipient who is restrained and secluded shall be observed by a
qualified person as often as is clinically appropriate but in
no event less than once every 15 minutes.
    (f) Safety precautions shall be followed to prevent
injuries to the recipient in the seclusion room. Seclusion
rooms shall be adequately lighted, heated, and furnished. If a
door is locked, someone with a key shall be in constant
attendance nearby.
    (g) Whenever seclusion is used, the recipient shall be
advised of his right, pursuant to Sections 2-200 and 2-201 of
this Code, to have any person of his choosing, including the
Guardianship and Advocacy Commission notified of the
seclusion. A person who is under guardianship may request that
any person of his choosing be notified of the seclusion whether
or not the guardian approves of the notice. Whenever the
Guardianship and Advocacy Commission is notified that a
recipient has been secluded, it shall contact that recipient to
determine the circumstances of the seclusion and whether
further action is warranted.
(Source: P.A. 86-1013; 86-1402; 87-124; 87-530; 87-895.)
 
    Section 99. Effective date. This Act takes effect upon
becoming law.